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JAMA Neurol:警惕TNF抑制剂治疗导致的炎症性CNS事件风险

2020-05-26 MedSci原创 MedSci原创

自身免疫性疾病患者接受TNF抑制剂导致炎症性CNS事件的风险增加

肿瘤坏死因子(TNF)抑制剂是治疗某些自身免疫性疾病的常用药物,如类风湿性关节炎。近日研究人员考察了使用肿瘤坏死因子抑制剂与炎症性中枢神经系统(CNS)事件之间的关系。
 
研究人员收集2003年1月1日至2019年2月20日梅奥诊所自身免疫性疾病患者病例,患者接受经美国食品和药物管理局批准的TNF抑制剂治疗自身免疫性疾病,包括类风湿关节炎、强直性脊柱炎、银屑病、银屑病关节炎、克罗恩病和溃疡性结肠炎。记录患者TNF抑制剂暴露、类型和累积暴露时间。研究的主要结果是炎症性脱髓鞘(多发性硬化和其他疾病,如视神经炎)或非脱髓鞘(脑膜炎、脑膜脑炎、脑炎、神经结节病和CNS血管炎)CNS事件。
 
共有212名患者参与研究,其中106名有炎症CNS事件的患者和106名对照组参与者,其中女性136例(64%),平均发病年龄52岁。64名患者(60%)和42名对照组(40%)暴露于TNF抑制剂,与任何炎症性CNS事件的风险增加相关(校正OR:3.01)。当结果按脱髓鞘和非脱髓鞘CNS事件分层时,结果是相似。二次分析发现,类风湿关节炎患者(校正OR:4.82)的相关性最为显著。
 
研究发现,自身免疫性疾病患者接受TNF抑制剂导致炎症性CNS事件的风险增加。
 
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  1. [GetPortalCommentsPageByObjectIdResponse(id=1852385, encodeId=44861852385cf, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Dec 20 20:38:19 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914264, encodeId=069119142647b, content=<a href='/topic/show?id=4b8349356f' target=_blank style='color:#2F92EE;'>#CNS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4935, encryptionId=4b8349356f, topicName=CNS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c737344, createdName=lg.zhao, createdTime=Sat Jan 02 22:38:19 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001053, encodeId=8416200105373, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Feb 10 07:38:19 CST 2021, time=2021-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401773, encodeId=ffd41401e731d, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Thu May 28 09:38:19 CST 2020, time=2020-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547330, encodeId=511c154e3309a, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Thu May 28 09:38:19 CST 2020, time=2020-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036105, encodeId=6cf41036105cb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 26 21:38:19 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
    2020-12-20 jklm09
  2. [GetPortalCommentsPageByObjectIdResponse(id=1852385, encodeId=44861852385cf, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Dec 20 20:38:19 CST 2020, time=2020-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914264, encodeId=069119142647b, content=<a href='/topic/show?id=4b8349356f' target=_blank style='color:#2F92EE;'>#CNS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4935, encryptionId=4b8349356f, topicName=CNS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c737344, createdName=lg.zhao, createdTime=Sat Jan 02 22:38:19 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001053, encodeId=8416200105373, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Feb 10 07:38:19 CST 2021, time=2021-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401773, encodeId=ffd41401e731d, content=<a href='/topic/show?id=17e21e57943' target=_blank style='color:#2F92EE;'>#TNF#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17579, encryptionId=17e21e57943, topicName=TNF)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqjVbfRD4f4vibEcZVcvato8Qib1gGtZJiayXCMFgHrkeErSiaxdYMiabKGxY2an9muxWCkUJbjFPViaC6A/132, createdBy=e4fb2361580, createdName=snowpeakxu, createdTime=Thu May 28 09:38:19 CST 2020, time=2020-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547330, encodeId=511c154e3309a, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Thu May 28 09:38:19 CST 2020, time=2020-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036105, encodeId=6cf41036105cb, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue May 26 21:38:19 CST 2020, time=2020-05-26, status=1, ipAttribution=)]
    2021-01-02 lg.zhao
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    2021-02-10 yinhl1978
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    2020-05-28 snowpeakxu
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    2020-05-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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